Evaluation of volumetric measurements in patients with acute type B aortic dissection – thoracic endovascular aortic repair (TEVAR) vs conservative
| Autor: | Iris E. Chemelli-Steingruber, Renate Hiemetzberger, Andreas Chemelli, Alexander Strasak, Benedikt V. Czermak, Beate Hugl |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Aortic Rupture Aorta Thoracic Aortography Aortic aneurysm Blood Vessel Prosthesis Implantation Aneurysm medicine.artery medicine Humans Thrombus Aortic rupture Aged Retrospective Studies Aortic dissection Aged 80 and over Aorta medicine.diagnostic_test Aortic Aneurysm Thoracic business.industry Angiography Digital Subtraction Thrombosis Middle Aged medicine.disease Surgery Aortic Dissection Treatment Outcome Cardiothoracic surgery Angiography Disease Progression Radiographic Image Interpretation Computer-Assisted Female Radiology business Cardiology and Cardiovascular Medicine Tomography Spiral Computed Dilatation Pathologic |
| Zdroj: | Journal of Vascular Surgery. (1):20-28 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2008.08.062 |
| Popis: | Objective The aim of this retrospective study was to evaluate aortic volume changes in patients with acute type B aortic dissection (TBD), treated either by thoracic endovascular aortic repair (TEVAR) or conservatively. Materials and Methods From July 1996 through March 2008, 76 patients presenting with acute TBD were referred to our department. To ensure a follow-up of at least 24 months, only 64 of them were included in the present study, with the cut-off for inclusion being March 2006. Twenty-nine of these patients underwent TEVAR and 35 patients underwent conservative treatment. Indications for TEVAR were life-threatening symptoms. Follow-up was performed postinterventionally in patients after TEVAR and at 3, 6, and 12 months, and yearly thereafter in both groups. It included clinical examinations, computed tomography (CT) scans, analysis of volume changes in true thoracic lumen (TTL), false thoracic lumen (FTL), thoracic lumen (TL), abdominal lumen (AL), and aortic diameter measurements. In addition, the extent of thrombosis and its influence on volume changes were assessed. Results Mean follow-up was 41 months after TEVAR and 46 months in the conservatively-treated patients. At 60 months, cumulative rates of freedom from dissection-related death and rupture-free survival were 82.6% and 93.1% in the TEVAR group, respectively. They were 74.9% and 88.5% in the conservatively-treated group, respectively. In the conservatively-treated patients, 3 patients died of late aortic rupture, 4 were converted to open surgery, and 2 to TEVAR. Evaluation of volume changes showed better results in the TEVAR group within 24 months. However, within 60 months the difference between the two groups was no longer relevant. Relating to thrombosis of the FTL, analyses showed slightly better overall results and promotion of thrombus formation after TEVAR. However, at 60 months the results showed a tendency towards approximation between the two groups. Conclusion Our data suggest that TEVAR seems to delay the natural course of the disease but not to stop it. |
| Databáze: | OpenAIRE |
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